SB3324 • 2026

RELATING TO MEDICAID.

Budget Children Healthcare

Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor: MORIWAKI
Last action: 2026-05-08
Official status: Enrolled to Governor.
Effective date: Not listed

Plain English Breakdown

The bill does not explicitly state that it aims to improve wages and benefits for caregivers, although this could be a potential outcome of increased funding.

Medicaid Funding Increase

This bill appropriates funds to increase Medicaid home- and community-based services funding in Hawaii, including residential care homes, and requires the Department of Human Services to obtain federal matching funds.

What This Bill Does

Appropriates funds to increase Medicaid home- and community-based services funding for residential services offered in community care foster family homes and expanded adult residential care homes.
Requires the Department of Human Services (DHS) to obtain maximum federal matching funds available for this appropriation.

Who It Names or Affects

People who receive Medicaid home- and community-based care services
Caregivers working in residential care homes

Terms To Know

Medicaid: A government program that helps people with low income pay for medical costs.
Community Care Foster Family Homes: Homes where foster children or adults needing care live and receive support services.

Limits and Unknowns

The bill does not specify how the increased funding will be used beyond obtaining federal matching funds.
It is unclear if this increase in funding will fully address the financial challenges faced by service providers.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

CD1

Hawaii published version CD1

Plain English: SB3324 CD1 THE SENATE S.B.

SB3324 CD1 THE SENATE S.B.
NO.
3324 THIRTY-THIRD LEGISLATURE, 2026 S.D.
1 STATE OF HAWAII H.D.

HD1

Hawaii published version HD1

Plain English: SB3324 HD1 THE SENATE S.B.

SB3324 HD1 THE SENATE S.B.
NO.
3324 THIRTY-THIRD LEGISLATURE, 2026 S.D.
1 STATE OF HAWAII H.D.

SD1

Hawaii published version SD1

Plain English: SB3324 SD1 THE SENATE S.B.

SB3324 SD1 THE SENATE S.B.
NO.
3324 THIRTY-THIRD LEGISLATURE, 2026 S.D.
1 STATE OF HAWAII A BILL FOR AN ACT RELATING TO MEDICAID .

Bill History

2026-05-08 S
Enrolled to Governor.
2026-05-08 S
Received notice of passage on Final Reading in House (Hse. Com. No. 888).
2026-05-06 H
Received notice of Final Reading (Sen. Com. No. 816).
2026-05-06 S
Passed Final Reading, as amended (CD 1). Ayes, 25; Aye(s) with reservations: none . 0 No(es): none. 0 Excused: none.
2026-05-06 H
Passed Final Reading as amended in CD 1 with none voting aye with reservations; none voting no (0) and none excused (0).
2026-05-01 H
Forty-eight (48) hours notice Wednesday, 05-06-26.
2026-05-01 H
Reported from Conference Committee (Conf Com. Rep. No. 201-26) as amended in (CD 1).
2026-05-01 S
48 Hrs. Notice (as amended CD 1) 05-06-26.
2026-05-01 S
Reported from Conference Committee as amended CD 1 (Conf. Com. Rep. No. 201-26).
2026-05-01 H
The Conference Committee recommends that the measure be Passed, with Amendments. The votes were as follows: 3 Ayes: Representative(s) Marten, Keohokapu-Lee Loy, Alcos; Ayes with reservations: none; 0 Noes: none; and 0 Excused: none.
2026-05-01 S
The Conference committee recommends that the measure be PASSED, WITH AMENDMENTS. The votes of the Senate Conference Managers were as follows: 2 Aye(s): Senator(s) San Buenaventura, Moriwaki; Aye(s) with reservations: none ; 0 No(es): none; and 1 Excused: Senator(s) Fevella.
2026-04-30 H
Conference Committee Meeting will reconvene on Friday 05-01-26 1:45PM in conference room 329.
2026-04-27 H
Bill scheduled for Conference Committee Meeting on Thursday, 04-30-26 1:45PM in conference room 329.
2026-04-23 H
Received notice of Senate conferees (Sen. Com. No. 739).
2026-04-23 S
Senate Conferees Appointed: San Buenaventura Chair; Moriwaki Co-Chair; Fevella.
2026-04-21 S
Received notice of appointment of House conferees (Hse. Com. No. 800).
2026-04-21 H
House Conferees Appointed: Marten, Keohokapu-Lee Loy Co-Chairs; Alcos.
2026-04-16 H
Received notice of disagreement (Sen. Com. No. 710).
2026-04-16 S
Senate disagrees with House amendments.
2026-04-16 S
Received from House (Hse. Com. No. 778).
2026-04-14 H
Passed Third Reading with none voting aye with reservations; none voting no (0) and none excused (0). Transmitted to Senate.
2026-04-10 H
Deferred one day 04-14-26.
2026-04-10 H
Reported from FIN (Stand. Com. Rep. No. 2081-26), recommending passage on Third Reading.
2026-04-07 H
The committee on FIN recommend that the measure be PASSED, UNAMENDED. The votes were as follows: 15 Ayes: Representative(s) Todd, Takenouchi, Hartsfield, Hussey, Keohokapu-Lee Loy, Kitagawa, Kusch, Lee, M., Miyake, Morikawa, Templo, Yamashita, Alcos, Gedeon, Reyes Oda; Ayes with reservations: none; Noes: none; and 1 Excused: Representative(s) Perruso.
2026-04-02 H
Bill scheduled to be heard by FIN on Tuesday, 04-07-26 2:00PM in House conference room 308 VIA VIDEOCONFERENCE.
2026-03-30 H
Passed Second Reading as amended in HD 1 and referred to the committee(s) on FIN with none voting aye with reservations; none voting no (0) and Representative(s) Cochran, Lowen, Perruso, Quinlan excused (4).
2026-03-30 H
Reported from HSH (Stand. Com. Rep. No. 1449-26) as amended in HD 1, recommending passage on Second Reading and referral to FIN.
2026-03-24 H
The committee on HSH recommend that the measure be PASSED, WITH AMENDMENTS. The votes were as follows: 9 Ayes: Representative(s) Marten, Olds, Amato, Hartsfield, Keohokapu-Lee Loy, Takayama, Takenouchi, Alcos, Garcia; Ayes with reservations: none; Noes: none; and Excused: none.
2026-03-20 H
Bill scheduled to be heard by HSH on Tuesday, 03-24-26 10:00AM in House conference room 329 VIA VIDEOCONFERENCE.
2026-03-12 H
Referred to HSH, FIN, referral sheet 17
2026-03-12 H
Pass First Reading
2026-03-10 H
Received from Senate (Sen. Com. No. 402) in amended form (SD 1).
2026-03-10 S
Report adopted; Passed Third Reading, as amended (SD 1). Ayes, 25; Aye(s) with reservations: none . Noes, 0 (none). Excused, 0 (none). Transmitted to House.
2026-03-05 S
48 Hrs. Notice 03-10-26.
2026-03-05 S
Reported from WAM (Stand. Com. Rep. No. 2840) with recommendation of passage on Third Reading, as amended (SD 1).
2026-03-03 S
The committee(s) on WAM recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in WAM were as follows: 12 Aye(s): Senator(s) Dela Cruz, Moriwaki, DeCoite, Elefante, Hashimoto, Inouye, Kanuha, Kidani, Kim, Lee, C., Richards, Wakai; Aye(s) with reservations: none ; 0 No(es): none; and 1 Excused: Senator(s) Fevella.
2026-02-25 S
The committee(s) on WAM deferred the measure until 03-03-26 10:15AM; Conference Room 211 & Videoconference.
2026-02-23 S
The committee(s) on WAM will hold a public decision making on 02-25-26 10:57AM; Conference Room 211 & Videoconference.
2026-02-20 S
Report adopted; Passed Second Reading and referred to WAM.
2026-02-20 S
Reported from HHS (Stand. Com. Rep. No. 2637) with recommendation of passage on Second Reading and referral to WAM.
2026-02-19 S
The committee(s) on HHS recommend(s) that the measure be PASSED, UNAMENDED. The votes in HHS were as follows: 5 Aye(s): Senator(s) San Buenaventura, McKelvey, Kanuha, Keohokalole, Fevella; Aye(s) with reservations: none ; 0 No(es): none; and 0 Excused: none.
2026-02-18 S
The committee(s) on HHS will hold a public decision making on 02-19-26 12:45PM; CR 016 & Videoconference.
2026-02-18 S
The committee on HHS deferred the measure.
2026-02-13 S
The committee(s) on HHS has scheduled a public hearing on 02-18-26 1:00PM; Conference Room 225 & Videoconference.
2026-02-02 S
Referred to HHS, WAM.
2026-01-30 S
Passed First Reading.
2026-01-30 S
Introduced.

Official Summary Text

RELATING TO MEDICAID.
DHS; Medicaid; Med-QUEST; Home- and Community-Based Services; Residential Services; Community Care Foster Family Homes; Expanded Adult Residential Care Homes; Federal Matching Funds; Appropriation ($)
Appropriates funds to the Department of Human Services to increase funding for certain Medicaid home- and community-based services, including residential services offered in community care foster family homes and expanded adult residential care homes. Requires the Department to obtain matching federal funds and pursue additional funding sources as a condition for expending the appropriated funds. (CD1)

Current Bill Text

Read the full stored bill text

SB3324

THE SENATE

S.B. NO.

3324

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

A BILL FOR AN ACT

Relating
to Medicaid
.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

����
SECTION 1.
�
The
legislature finds that, in a 2021 quantitative research study, the AARP found
that, among Hawaii residents aged forty-five and older, seventy-five per cent of
the respondents reported that having affordable long-term care options in their
communities was an important independent living issue.
�
Respondents also reported that maintaining a
connection with family and friends and the ability to continue visiting
familiar health care providers are significantly easier when the State's kupuna
can be cared for closer to home.
�
The
legislature recognizes that, in 2026, a strong demand for community-based care options
for kupuna still exists.

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The legislature further finds that the latest
review of the State's home and community-based medicaid reimbursement rates for
residential services was a third-party study conducted by the actuarial firm
Milliman, published on December 30, 2022.
�

The study developed benchmark comparison rates for certain home and
community-based services, including residential services provided in community
care foster family homes and expanded adult residential care homes.
�
Notably, amongst all provider types examined
in the Milliman study, the current median direct care wages paid to home and
community-based services providers fell below the twenty-fifth percentile for
those occupation codes and titles as determined by the United States Bureau of
Labor Statistics.

����
The legislature also finds that, in 2024, a
recurring budget appropriation for residential settings rates was enacted.
�
The appropriation was passed as a budget line-item
reflecting an annual state share increase of $5,750,000 for select home and
community-based services.
�
This increase
was inclusive of residential services for community care foster family homes
and expanded adult residential care homes, effective in 2025 and beyond, and
reflected the "low" rate scenario for the residential services
included in Milliman's 2022 rate study.

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The legislature acknowledges that, while
meaningful, the 2024 appropriation was inadequate.
�
Service providers remain unable to offer
benefits, including health insurance, to their employees and continue to rely
on substitute caregivers, sometimes unpaid, including family members and
friends of the providers.
�
Additionally,
high inflation has persisted, further increasing costs for operators providing
residential services in community care foster family homes and expanded adult
residential care homes.
�
The result of
these ongoing financial pressures is that few providers are able to operate
sustainably, leading to limited community-based care options for Hawaii's
kupuna.

����
Accordingly, the purpose of this Act is to:

����
(1)
�
Appropriate
moneys to increase the funding of residential services offered in community
care foster family homes and expanded adult residential care homes to the
"medium" rate scenario published in Milliman's 2022 rate study; and

����
(2)
�
Require
the department of human services to obtain the maximum federal matching funds
available for the increased expenditure, which will result in a larger impact
on reimbursements paid to service providers.

����
SECTION 2.
�

There is appropriated out of the general revenues of the State of Hawaii
the sum of $5,810,000 or so much thereof as may be necessary for fiscal year
2026-2027 to increase funding for certain medicaid home- and community-based
services, including residential services offered in community care foster
family homes and expanded adult residential care homes; provided that no sum
shall be expended unless the department of human services:

����
(1)
�
Obtains
the maximum federal matching funds available for this appropriation; and

����
(2)
�
Exhaustively
pursues all funding sources identified by the State, including private grants.

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The sum appropriated shall be expended by
the department of human services for the purposes of this Act.

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SECTION 3.
�

This Act shall take effect on July 1, 2026.

INTRODUCED BY:

_____________________________

Report Title:

DHS;
Medicaid; Med-QUEST; Home- and Community-Based Services; Residential Services;
Community Care Foster Family Homes; Expanded Adult Residential Care Homes;
Federal Matching Funds; Appropriation

Description:

Appropriates
moneys to the Department of Human Services to increase funding for certain
Medicaid home- and community-based services, including residential services
offered in community care foster family homes and expanded adult residential
care homes.
�
Requires the Department to
obtain matching federal funds and to pursue additional funding sources.

The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.